Nursing Elites

1. When using the Ballard gestational assessment tool on a newborn, which of the following tests should be performed after the first hour of birth, allowing the newborn to recover from the stress of birth?

• A. Arm recoil
• B. Square window sign
• C. Scarf sign
• D. Popliteal angle

Correct answer: A

Rationale: The correct answer is Arm recoil. Arm recoil is slower in healthy but fatigued newborns after birth, making it best elicited after the first hour of birth when the baby has had time to recover from the stress of birth. This assessment helps evaluate neuromuscular maturity in newborns and is more accurate when performed after the initial recovery period. The other choices, Square window sign, Scarf sign, and Popliteal angle, are not specifically assessed using the Ballard gestational assessment tool and do not relate to the recovery period after birth.

2. The word hormone is derived from the Greek 'hormao' meaning 'I excite or arouse.' Hormones communicate this effect through their unique chemical structures recognized by specific receptors on their target cells, their patterns of secretion, and their concentrations in the general or local circulation. Which of the following is NOT a function of hormones?

• A. Producing new offspring
• B. Promoting growth and enhancing beauty
• C. Maintaining body temperature
• D. Fighting infections

Correct answer: A

Rationale: Hormones play a crucial role in various bodily functions such as regulating metabolism, growth, and maintaining homeostasis. However, producing new offspring involves reproductive processes controlled by other systems in the body, not directly by hormones.

3. A child is being admitted to the hospital for probable pneumonia. The nurse asks what the parents have done at home for this illness. The parent comments that they have given the child a tea made up of herbs that a neighbor recommended. The parents ask if that is a safe thing to do. The most appropriate response for the nurse is:

• A. Sure, if it doesn't make the child worse, it could help.
• B. Of course, teas are rarely harmful.
• C. It might be safe for adults, but research might not have been conducted on the effects on children.
• D. Absolutely not, herbal teas are not appropriate for children.

Correct answer: C

Rationale: The most appropriate response is C: 'It might be safe for adults, but research might not have been conducted on the effects on children.' This response acknowledges the potential differences in the effects of herbal teas on adults versus children and highlights the importance of considering the lack of specific research on this topic when it comes to pediatric care. Choice A is incorrect because assuming something is safe without evidence can be risky in a pediatric setting. Choice B is also incorrect as it oversimplifies the safety of herbal teas. Choice D is too definitive and does not consider the possibility that herbal teas might have different effects on children than on adults.

4. A 6-year-old child is admitted to the hospital with pneumonia. An immediate priority in this child's nursing care would be:

• A. Elimination
• B. Exercise
• C. Nutrition
• D. Rest

Correct answer: D

Rationale: Rest is crucial for recovery in a child with pneumonia as it allows the body to focus its energy on fighting the infection and promoting healing. Adequate rest helps reduce the workload on the lungs, promotes oxygenation, and supports the immune system's response to combat the infection. It is essential to prioritize rest to facilitate a faster recovery and prevent complications in children with pneumonia.

5. What characteristic indicates that a mass on a newborn's head is a cephalohematoma?

• A. The mass appears on the second day after birth.
• B. The mass grows larger when the newborn cries.
• C. The head appears asymmetrical.
• D. The mass is located on only one side of the head.

Correct answer: A

Rationale: A cephalohematoma typically appears between the first and second days after birth, making choice A the correct answer. It results from blood vessel rupture between a cranial bone and the periosteal membrane. Choices B, C, and D are incorrect because the growth of the mass when the newborn cries, asymmetrical head appearance, or the mass being located on only one side of the head are not specific indicators of a cephalohematoma.

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